Alarming provisional coroner figures indicate that between 40-45 people died from synthetic drugs in the previous 12 months. Three health experts – including an Emergency Medicine Specialist – shared their responses with the Science Media Centre.

The key to reducing the use of synthetic cannabinoids is to try and find out more about what is driving demand.

Interviews of users of ‘synnies’ uniformly state that they do not enjoy smoking them and that when compared to other recreational drugs they are ‘shit’.

They are also aware of the harms that ‘synnies’ cause, with many of them witnessing associates collapsing, fitting, acting like zombies, and some have had friends die from their use. Yet, despite this, they continue to seek and use them avidly.

Addiction is certainly one of the reasons they continue. The very high potency of these agents means that they become dependent upon them very quickly and need to continue to consume to prevent withdrawal. This has created a captured market for the dealers.

Deliberate price setting, ease of access and focused targeting of vulnerable populations by the dealers is a significant factor as well.

Users of ‘synnies’ often state that they would take something else but they cannot get hold of alternatives or afford them. Natural cannabis currently falls into this category being regarded as relatively hard and expensive to obtain (compared to ‘synnies’).

But not enough work is being done to investigate why users feel a need to use drugs and in particular ‘synnies’ in the first place. What is it about their lifestyle and psychosocial background that drives the to seek the escapism of drugs and alcohol to start with? Is there some form of community or social intervention we can do that would impact this dangerous demand?”

Supply

The large profit margin associated with the manufacture of synthetic cannabinoids combined with a very low level of associated peril is maintaining a very high level of supply to the community.

The raw product can be purchased for a few hundred dollars that then returns thousands in return. ($150 to $5,000 has been quoted in one example). As synthetic cannabinoids falls under the Psychoactive Substances Act 2013 then penalty for manufacture and sale is relatively low (maximum of two years) which is not seen as a deterrent.

Synthetic cannabinoids fulfil all of the criteria required to be made a Class A1 drug; addictive, harmful to society and, directly associated with death and other health harms.

However, placing ‘synnies’ as a Class A drug would then place users under significant threat of prosecution themselves. This is one of the leading reason why the Misuse of Drugs Act (MODA) needs to be completely revised and we need to explore decriminalisation for drug use versus increased penalties for manufacture, trafficking and supply.

One consideration is to use existing law to charge those who deal and supply an agent that is known to be illegal and results in death, they should be charged with manslaughter. That would be a significant deterrent and may have impact the market supply.

The majority of these agents are being imported / obtained via the dark web and via ‘mail’. Increased effort needs to be committed by the government to review internet security and to strengthen our border especially for high frequency low volume imports which is how synthetic cannabinoids are imported.

We’ve got an unbelievable number of people dying over a short period of time.

My view is the same as it was when we introduced the Psychoactive Substances Act, which is why don’t you legalise possession and use of cannabis, and I still see that as an essential part of countering this current, appalling number of deaths.

We should immediately be moving toward decriminalisation and allowing a far, far, far safer product. I don’t believe anybody has ever actually died from taking cannabis. That’s not to say it doesn’t have adverse health and other effects – it does – but they’re minuscule compared to alcohol, tobacco and synthetics. That approach needs to be accompanied by a big increase in what we’re putting into education around cannabis and other drugs.

The prohibition and war on drugs simply has not worked. Of all the money spent in relation of drugs – courts, police and health – one fifth of that total is spent on health. I’d like to see that turned around. So people who are caught, in relation to any substance, you don’t go to prison for it, you get referred for help. The Drug Foundation has put forward a sensible response to that. In the case of more harmful drugs, police would still issue a warning and confiscate but there would be pressure for people to engage in terms of getting help.

When the party pill thing was first introduced – they were pretty innocuous. What happened was they became more toxic and that’s when action had to be taken to modify that.

We’ve learnt we need to communicate about these things very quickly. This one that’s happened over the last 12 months should have been picked up a lot sooner. Say there was an issue with the food or water supply and you had a few people die. There would be an immediate public health response. To have that many people die is absolutely appalling.

I would expect people wouldn’t know what they are having. That’s one of the dangers of an unregulated market.

My view is the personal use or possession of any drug should be decriminalised but that’s not to say they should be widely available. But have it out in the open and ensure that professional help is available for those who need it. In the case of recreational cannabis have it legal, regulated and taxed to help moderate use and provide funds for public education and treatment.

We should do everything we can to remove synthetics, but if cannabis was legally available and people were aware of some of the dangers of these other products – I believe the vast majority of people prone to use these other products would use cannabis. We also need to do much more to address massive social inequalities and other things that marginalise people and make them prone to anxiety, depression, substance misuse and ill-health.

Associate Professor Chris Wilkins, College of Health, SHORE & Whariki Research Centre, Massey University further comments:

The renewed political interest in responding to new high potency synthetic cannabinoids is a welcome development. The large number of synthetic cannabinoid compounds, the speed which they appear, their chemical diversity, and lack of research of their health risks present considerable challenges to the authorities.

The development of an early warning drug system was signalled as far back as 2015 as part of the National Drug Policy 2015-2020.

Much has been said about the need to develop enhanced toxicological testing to identify the presence of new synthetic cannabinoid compounds.

While toxicological analysis is a crucial component of a drug monitoring system, there are equally important challenges of developing a risk profile of new compounds and disseminating this risk information in a timely fashion to health professionals, and local youth and social workers, and indeed the drug users themselves.

Drug users are often entirely absent from thinking on the design of drug monitoring systems, and that is a great shame, as there is a clear overlap of interest between users and the authorities who both want to avoid fatalities related to the use of novel synthetic psychoactive compounds.